Okay so I started reading some birthing books. (skimming through Dr. Sear's, Bradley, & Hypnobirthing) and they all talk about different things to get labor going. I know this has been discussed on these boards a bunch too. My main question is if sex and nipple stimulation can get labor started, is there a cut-off point for when it is off limits so I don't accidentally start labor too early? Or is this stuff just old wives' tales and it doesn't matter anyways?

Back to the fluoride thing, Sven went to the dentist today and he said that since we filter our water, I should use fluoridated toothpaste specifically because he'll swallow it. Works for me, I guess! He also recommended using the Spry Xylitol tooth gel 4-5 times a day (after eating) until it gets easier to brush his teeth well. I guess you just put in on a cloth or brush and swipe it across the teeth.

Okay so I started reading some birthing books. (skimming through Dr. Sear's, Bradley, & Hypnobirthing) and they all talk about different things to get labor going. I know this has been discussed on these boards a bunch too. My main question is if sex and nipple stimulation can get labor started, is there a cut-off point for when it is off limits so I don't accidentally start labor too early? Or is this stuff just old wives' tales and it doesn't matter anyways?

none of those things worked for me, i wouldn't recommend them!! and god knows we tried.i did hear about cohosh and something else- some kind of oil? or maybe it was senna? like a super strong laxative that was supposed to just move things along (didn't seem too scientific to me) but both sounded like a violent way to begin labor so I avoided them.

Castor oil is supposed to work that way torque, but my midwife advised against it for the reason you mentioned..the mom is so exhausted before labor starts that it makes things harder. (also, it doesn't always work and then you're sick as a dog for nothing)

Okay so I started reading some birthing books. (skimming through Dr. Sear's, Bradley, & Hypnobirthing) and they all talk about different things to get labor going. I know this has been discussed on these boards a bunch too. My main question is if sex and nipple stimulation can get labor started, is there a cut-off point for when it is off limits so I don't accidentally start labor too early? Or is this stuff just old wives' tales and it doesn't matter anyways?

A friend of mine who went to 42w1d tried everything and either time or castor oil finally did it for her.

I got put on "pelvic rest" from like 35w6d until I reached 37w-ish because I was already fully effaced and a cm or 2 dilated at that point and my midwife didn't want things moving along until I was cleared for home birth. At some point around 37.5w we attempted sexytimes and I ended up with painful enough contractions that we just decided to cut that shiitake out until after V was born (which happened a week later).

Which comes first, picking a hospital or picking an obstetrician? Are obstetricians connected to certain hospitals, so you pick the hospital first? Or does the obstetrician follow you to the hospital you choose, assuming both are local?

Obstetricians have privileges at certain hospitals and can only practice there. If you love your OB or midwife, you may be willing to follow them anywhere, but for me, I looked at c-section rates and picked a hospital that I could get vegan food and that would support a natural birth and let me labor in a tub (sadly didn't get to do that). Three of the closest hospitals to me were just a bad fit - at one my friend didn't get a vegan meal despite talking to them for weeks beforehand and another friend got MRSA 2x there and the other has a 60%+ c-section rate and my friend who birthed there said they didn't give her a choice about an epidural and the third one I just don't like.

_________________My oven is bigger on the inside, and it produces lots of wibbly wobbly, cake wakey... stuff. - The PoopieB.

I also picked the hospital first. I really only had 2 main choices, and the one I picked has the better NICU (just in case) and allows practices with midwives. The other hospital has to helicopter babies out if something major goes wrong, and has no midwives with privileges. After that, I went to the hospital's website to look at which practices had OBs and midwives. Oddly enough the one I picked is the older hospital with smaller rooms etc, but the brand new fancy hospital wasn't as important to me as the other stuff.

Of course this depends on where you live. My sister thought I was crazy because the only place to deliver near her is the one hospital in town and every doctor obviously went there.

Joined: Fri Apr 01, 2011 11:51 amPosts: 6561Location: United States of New England

mollyjade wrote:

Which comes first, picking a hospital or picking an obstetrician? Are obstetricians connected to certain hospitals, so you pick the hospital first? Or does the obstetrician follow you to the hospital you choose, assuming both are local?

decide whichever is more important to you. is there a hospital you really want to give birth at or a dr you really love?

then pick that first. and the rest sort of falls into place.when i picked my OB it meant i had to give birth at UMASS Memorial which is what i wanted anyways so it worked out well for me.

you also may want to think about whether you want a midwife or an OB. i think within the hospital system of UMASS the midwives are at one of the hospitals that is farther away from me and not at UMASS Memorial, so they may only have priviledges at certain facilities. not 100% sure about that.

Joined: Fri Apr 01, 2011 11:51 amPosts: 6561Location: United States of New England

Tofulish has a good point about the C-section rate. make sure you ask about that if that is important to you.

i lucked out and UMASS has an insanely low C-section rate. something ridiculous like 11%.

one of the other very famous hospitals in MA (i think Newton-Wellesley but im not 100% sure) had a ridiculously high c-section rate. that can sometimes tell you that the Dr's looking at birthing women as surgical cases rather than a natural phenomenon.

Joined: Fri Apr 01, 2011 11:51 amPosts: 6561Location: United States of New England

mollyjade wrote:

Or does the obstetrician follow you to the hospital you choose, assuming both are local?

im sorry i didnt mean to reply 3 seperate times but i just kept thinking up new things.

dont assume that your local hospital delivers babies (unless you just happen to know this already). we have a hospital literally 4 mins from my house and my OB does have priviledges there and i was trying to decide whether to deliver at the local hospital or drive into Worcester (20-25 mins in no traffic) to UMASS and when i asked my OB if the local one was good she laughed at me and was all like "oh nooooo they dont deliver babies there"

Just want to throw out there that c-section rates should be looked at in the context of the services the hospital offers. I ended up having a home birth, but the hospital I started seeing had a nice low c-section rate (~20%). I later learned that this was because all the higher risk births got sent to a different hospital, which had a 40% rate. It's a useful number but it doesn't always tell the whole story.

Beyond that from my own experiences I would say, first learn about all your options and decide whether you even want an OB, or a hospital. And realize that you can change providers if it's not a good fit. I am so, so happy that I left the care of the hospital when it became clear to me that I was not going to be participating in any decisionmaking there.

Just want to throw out there that c-section rates should be looked at in the context of the services the hospital offers. I ended up having a home birth, but the hospital I started seeing had a nice low c-section rate (~20%). I later learned that this was because all the higher risk births got sent to a different hospital, which had a 40% rate. It's a useful number but it doesn't always tell the whole story..

very much so. the hospital i chose did all high risk cases in the region, and so there was a much higher rate, although they bent over backwards to not do a C-section.

Since you know you'll be high risk, I'm assuming you have some pre-existing health condition(s) that would affect pregnancy-- do you already see any specialists (that you like, obviously) who are associated with either hospital? I have a thyroid disorder, so I see an endocrinologist at one hospital, but I chose an OB at a different hospital. It would have made things a lot simpler if my endo and OB had been at the same hospital, but I hadn't really thought about that when choosing providers for pregnancy.

Since you know you'll be high risk, I'm assuming you have some pre-existing health condition(s) that would affect pregnancy-- do you already see any specialists (that you like, obviously) who are associated with either hospital? I have a thyroid disorder, so I see an endocrinologist at one hospital, but I chose an OB at a different hospital. It would have made things a lot simpler if my endo and OB had been at the same hospital, but I hadn't really thought about that when choosing providers for pregnancy.

I have type 1 diabetes and thyroid disease. I have no idea what hospital my endo is associated with. That's a good question. I'll have to ask.

The C-section rate question is really complicated. From what I've read, taking more higher risk patients or having a level three NICU does not seem to correlate with higher C-section rates in general - primarily because C-section rates are too high almost everywhere and because CBAC (cesarean birth after a cesarean) rates are near 100% in most areas, so at least 25% of second-time-around mothers, even if otherwise low risk are likely to be having a C-section at a low risk profile hospital (and the numbers go up with the number of children you've had).

I'd be curious to see where Tofulish got her numbers on local hospital C-section rates such that there were meaningful differences locally, though, because the stats listed for NJ hospitals on The Unnecessarean don't show significant differences in local hospitals (maybe Mountainside was different?, I don't remember their numbers, but I'm pretty sure they were all uniformly high). Then there are a couple outlier hospitals that don't do planned births, but will wind up with a handful of cases each year of someone walking into the hospital crowning and they'll have crazy stats like 2% C-section rates. None of the hospitals in our area that do planned births have rates under 40%, so my question to my providers was what their personal C-section stats were (they claimed ~10%) and what were the stats on their covering midwives or physicians. Then you have to look at the surrounding hospital system and how supportive it is of natural birth (even if you want an epidural, need an induction, etc., if they're supportive of natural birth, they're likely more supportive of you as a human being in general). Basically, it's complicated. But I think it's equal parts provider attitudes/practices and hospital policies that you wind up dealing with.

I've also read that you should find out the c-section rate of your particular doctor/practice (if they will give you that info) and the policies of the hospital that lead to c-sections (fetal monitoring, time limits on labor etc) instead of just the rate of the hospital in general. I'm not sure how you get all this info though. Of course this is probably just over thinking everything :)

Joined: Fri Apr 01, 2011 11:51 amPosts: 6561Location: United States of New England

mollyjade you could ask your endo if they have worked with any particular OB's before or have patients who went to OB's they liked.it's possible many of your endo's other patients have already gone through this and have used someone they like.

I've also read that you should find out the c-section rate of your particular doctor/practice (if they will give you that info) and the policies of the hospital that lead to c-sections (fetal monitoring, time limits on labor etc) instead of just the rate of the hospital in general. I'm not sure how you get all this info though. Of course this is probably just over thinking everything :)

It's only overthinking if it leads to nothing, and then it becomes super depressing - so sad that unfortunately all of those numbers were pretty much the same for all the hospitals I would have access to and I think that's generally the case in most areas of the country - continuous monitoring is absolutely the norm, 24 hour time limits on labor are the norm, amniotomy is the norm, etc. (things might be different in specialized hospitals, military hospitals, tiny hospitals, etc.). On those issues it seems most important to go with a provider who has a history of doing things their own way and has worked in a hospital who knows how that provider does things (for example, going with midwives meant I had the possibility of using the tub at the hospital, doing intermittent monitoring, having a heplock instead of an IV, etc. and the hospital staff was cool with it because they knew that's how that practice worked). [Also, I don't know if this would be possible/prudent considering your other health issues, but are there any freestanding birth centers around for you to look into?]

It's weird because there are hospitals around here where it's clear that there's a much more resistant, difficult stance toward physiological birth even though their C-section and epidural rates are really pretty much identical to the more mother/baby-friendly hospitals around. How would one get to know that? Talk to friends who've had babies at the different places and then go with your gut about your provider. You could also take a tour at the hospitals you have available to you early on and pose those kinds of questions (might be hard to get the patient advocate who gives the tour to give you any stats, though). The Unnecessarean website is a really good place to go for hospitals' C-section, VBAC, and epidural use stats, though! They have data on most states.

Joined: Fri Apr 01, 2011 11:51 amPosts: 6561Location: United States of New England

is having an IV jammed in you as soon as you arrive at the hospital pretty standard?ive been finishing up reading the Sears pregnancy book and i just finished Your Vegetarian Pregnancy and the end of both books talk about labor and birth plans, etc and ive been giving more thought to my "birth plan"normally im pretty laid back and do what im told, in the interest of "these people are professionals they know what they are doing"

but after reading through these books and reading this forum ive come to a small number of things i really do or do NOT want.

i DO NOT want to be inducedi DO NOT want a c-sectioni DO NOT want to be connected to an IV.

obviously medical emergency trumps all and im totally willing to listen to people as things happen and weigh my options but i dont want to have an IV jammed in me the second i walk in the door. i hate needles. ive been in the hospital twice before and i remember both times just wanting to pull the IV out myself because i dont like this THING hanging out of my arm. i remember both times at the end of my stay begging to have them take the damn thing out :-P

i dont know what a heplock is but it sounds like the IV is started but not connected so you still have something in your arm?? i want to be able to get up and move around and walk.

i know these are things i have to talk to about with my Dr when the time comes but it seems like whether or not you get an IV would be standard hospital procedure.

to me if you are having a "normal" labor you dont need an IV. people have home births with no IVs so it seems unnecessary to me, unless there is a medical need for it.

I've also read that you should find out the c-section rate of your particular doctor/practice (if they will give you that info) and the policies of the hospital that lead to c-sections (fetal monitoring, time limits on labor etc) instead of just the rate of the hospital in general. I'm not sure how you get all this info though. Of course this is probably just over thinking everything :)

It's only overthinking if it leads to nothing, and then it becomes super depressing - so sad that unfortunately all of those numbers were pretty much the same for all the hospitals I would have access to and I think that's generally the case in most areas of the country - continuous monitoring is absolutely the norm, 24 hour time limits on labor are the norm, amniotomy is the norm, etc. (things might be different in specialized hospitals, military hospitals, tiny hospitals, etc.). On those issues it seems most important to go with a provider who has a history of doing things their own way and has worked in a hospital who knows how that provider does things (for example, going with midwives meant I had the possibility of using the tub at the hospital, doing intermittent monitoring, having a heplock instead of an IV, etc. and the hospital staff was cool with it because they knew that's how that practice worked). [Also, I don't know if this would be possible/prudent considering your other health issues, but are there any freestanding birth centers around for you to look into?]

It's weird because there are hospitals around here where it's clear that there's a much more resistant, difficult stance toward physiological birth even though their C-section and epidural rates are really pretty much identical to the more mother/baby-friendly hospitals around. How would one get to know that? Talk to friends who've had babies at the different places and then go with your gut about your provider. You could also take a tour at the hospitals you have available to you early on and pose those kinds of questions (might be hard to get the patient advocate who gives the tour to give you any stats, though). The Unnecessarean website is a really good place to go for hospitals' C-section, VBAC, and epidural use stats, though! They have data on most states.

There's actually a really great natural birthing center here, but there's no way I could use it. About 40% of type 1s are induced early (because of large babies) and 70% have c-sections (because of potential eye damage, failed induction, or damaged nerves that interfere with pushing). And there are risks for the baby, too, like low blood sugar at birth. I should have a better idea of my personal risks after I talk with my eye doc. Women with preexisting diabetes generally have healthy babies, it just takes more monitoring and intervention.

mollyjade, yeah, I figured as much. There's been a lot of discussion about induction due to potential big babies (just for regular low risk women) and ACOG's statements about it are that just scheduling a C-section in the case of a suspected big baby makes a lot more sense than inducing since inducing a big baby will lead to exactly the same issues as any other kind of vaginal delivery would (shoulder dystocia being the biggest deal). On the other hand, it seems like if you go into pregnancy with pre-existing diabetes you'd be much better at controlling blood sugar and avoiding the big baby to begin with! My cousin has type II diabetes and was on insulin throughout her pregnancy. She had a C-section with a provider who doesn't offer anything but C-sections to diabetic patients because of big baby fear - her baby was under 7 pounds. So, seems like a complicated decision, you'll certainly need a lot of conversation with your provider - have you looked at MFM specialists as a possibility?

LisaPunk - as far as I can tell, routine IVs are, well, super routine. The argument for IVs goes like this: we don't want you to eat/drink during labor (this is not evidence-based), so you'll need IV fluids; if you get an epidural, you'll need an IV anyway; if you're continuously being monitored in bed anyway (also routine in the US), there's no extra restriction in movement caused by the IV; if you somehow manage to get through birth without pain meds, but you start hemorrhaging and they need to give you blood or fluids, you'll already have the IV (Pitocin given in that case can and usually is given with just a jab in the thigh, no IV required); if you need an emergency C-section, it'll be easiest if you already have an IV (if it's really an emergency, though, they will give you gas and you'll be totally out, IV or not). So the IV argument is reasonable if you're looking toward inevitable interventions or potential emergencies, but not reasonable if you're planning on eating/drinking in labor, moving around really freely, using the shower/tub, etc. I had a deal with my providers to not have any kind of IV at all, but then I tested positive for GBS and needed antibiotics in labor, so I went with the heplock, which is just the kind of IV that is designed to be not in use most of the time and intermittently hooked up. The bad part of the hep lock is that you still can't get the area wet and my nurses were a little dumbfounded about how to protect the site when I wanted to use the shower - would've really been difficult if I tried to use the tub. And then, in the end, I wound up on Pitocin so I was hooked up continuously and then also an epidural, and blah blah blah. So, you can't plan for that kind of stuff necessarily if things go south, but if you don't want an IV during labor, get your provider on board with that plan NOW. And if you don't want to be induced, talk to your provider about letting labor start on its own NOW and also what instances would cause them to want to induce you. It's helpful to have a birth plan about that stuff not only to have the plan, but to have a framework for having the conversation with the provider and with the nurses when you get to the hospital.